Chen Jun-Long, Zhang Chun-Li
Department of Neonatology, Inner Mongolia People's Hospital, Huhhot 010017, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2020 Jul;22(7):716-720. doi: 10.7499/j.issn.1008-8830.2001063.
To study the role of interleukin-33 (IL-33) in the development and progression of bronchopulmonary dysplasia (BPD) in preterm infants.
A prospective cohort study was performed on 128 preterm infants with a gestational age of ≤32 weeks and/or a birth weight of ≤1 500 g. They were classified to a non-BPD group with 50 infants, a mild BPD group with 32 infants, a moderate BPD group with 30 infants, and a severe BPD group with 16 infants. Related data were collected, including antepartum factors of mothers (antepartum hormone and chorioamnionitis), intrapartum factors of preterm infants (sex, gestational age, birth weight, mode of birth, and birth asphyxia), treatment after birth (pulmonary surfactant, duration of invasive ventilation, duration of noninvasive ventilation, duration of parenteral nutrition, and length of hospital stay). The high-risk factors for BPD were analyzed. ELISA was used to measure the serum level of IL-33 in preterm infants on days 1, 14, and 28 after birth. The serum level of IL-33 was compared between groups at different time points after birth. The preterm infants with moderate or severe BPD were treated with conventional corticosteroid therapy (DART regimen), and the serum level of IL-33 was measured before and after treatment.
There were significant differences between the preterm infants with BPD and those without BPD in the incidence of maternal chorioamnionitis, gestational age, birth weight, the incidence of birth asphyxia, duration of invasive ventilation, duration of noninvasive ventilation, duration of parenteral nutrition, and total length of hospital stay (P<0.05). There were significant differences in the above indices among the preterm infants with different severities of BPD (P<0.05). On days 1, 14, and 28 after birth, the infants with BPD had a significantly higher serum level of IL-33 than those without BPD, and the serum level of IL-33 tended to increase with the severity of BPD and over the time after birth (P<0.05). The preterm infants with moderate or severe BPD had a significant reduction in the serum level of IL-33 after the treatment with DART regimen (P<0.05).
Serum IL-33 is closely associated with the development and severity of BPD. Anti-inflammatory therapy with DART regimen can decrease the serum level of IL-33.
研究白细胞介素-33（IL-33）在早产儿支气管肺发育不良（BPD）发生发展中的作用。
对128例胎龄≤32周和/或出生体重≤1500g的早产儿进行前瞻性队列研究。将他们分为非BPD组50例、轻度BPD组32例、中度BPD组30例和重度BPD组16例。收集相关数据，包括母亲的产前因素（产前激素和绒毛膜羊膜炎）、早产儿的产时因素（性别、胎龄、出生体重、分娩方式和出生窒息）、出生后的治疗情况（肺表面活性物质、有创通气时间、无创通气时间、肠外营养时间和住院时间）。分析BPD的高危因素。采用酶联免疫吸附测定（ELISA）法检测早产儿出生后第1天、第14天和第28天血清IL-33水平。比较出生后不同时间点各组间血清IL-33水平。对中度或重度BPD的早产儿采用传统皮质类固醇治疗方案（DART方案）进行治疗，并在治疗前后检测血清IL-33水平。
BPD早产儿与非BPD早产儿在母亲绒毛膜羊膜炎发生率、胎龄、出生体重、出生窒息发生率、有创通气时间、无创通气时间、肠外营养时间和住院总时间方面存在显著差异（P<0.05）。不同严重程度BPD的早产儿上述指标存在显著差异（P<0.05）。出生后第1天、第14天和第28天，BPD早产儿血清IL-33水平显著高于非BPD早产儿，且血清IL-33水平随BPD严重程度加重及出生后时间延长呈上升趋势（P<0.05）。采用DART方案治疗后，中度或重度BPD早产儿血清IL-33水平显著降低（P<0.05）。
血清IL-33与BPD的发生发展及严重程度密切相关。DART方案抗炎治疗可降低血清IL-33水平。
